Measurement of the Maternal Serum 25 - Hydroxyvitamin D, Neutrophil - to - Lymphocyte Ratio and Paraoxonase 1 Levels in the Prediction of Spontaneous Preterm Birth

Abstract

Background: The main factor contributing to perinatal morbidity and mortality worldwide is preterm birth. Studies have linked a number of etiological factors, including vitamin D, oxidative stress (paraoxonase 1), and inflammatory markers, to the development of spontaneous preterm labour.

Objective: To investigate the value of maternal serum25hydroxy vitamin D, paraoxonase 1, and neutrophil to lymphocyte ratio in spontaneous preterm birth as markers of different pathogenesis pathways and to determine the correlation among them.

Patients and Methods: Prospective Case-control study in AL- Yarmouk Teaching Hospital/ Baghdad during the period (January- October) 2021, was performed on pregnant women referred to the hospital, 45 pregnant women who delivered spontaneous preterm labor were regarded as a case group and another 45 pregnant women without signs and symptoms of preterm labour with comparable gestational age who continued pregnancy till term regarded as a control group, maternal serum level of 25-hydroxyvitamin D, serum paraoxonase1 and neutrophil to lymphocyte ratio was measured in both groups.

Result: The level of 25 –hydroxyvitamin D and paraoxonase 1 level were significantly lower in case group women. p-value <0.05. The result showed that more preterm women had severe vitamin D deficiency <10 ng/ml. In the case group, a non-significant negative moderate correlation was found between vitamin D and paraoxonase1, and a non-significant negative very weak correlation was found between neutrophil to lymphocyte and paraoxonase1, regarding the control group there was a non-significant positive weak correlation was found between vitamin D and paraoxonase 1, and non-significant negative very weak correlation was found
between neutrophil to lymphocyte and paraoxonase 1.

Conclusion: The three parameters of three pathways act independently in the pathogenesis of preterm labour. Paraoxonase 1has the highest sensitivity among three variables and can be recommended for screening of preterm labour. The specificity of the three parameters is low suggesting a poor diagnostic performance.